Implantation of Foldable Iris-Claw Phakic IOL for High Myopia: Effectiveness and Safety of Procedure After 24-Month Follow-up
Purpose
To evaluate the effectiveness and the safety of phakic iris-claw IOL surgery for correction of high myopia after 24-month follow-up.
Methods
Retrospective study of patients that underwent phakic iris-claw IOL (Artiflex®, Ophtec BV, Groningen, The Netherlands) implantation for high myopia correction. Preoperative and 24-month follow-up data were analyzed regarding the best-corrected visual acuity (BCVA), spherical and cylindrical refractions and keratometry. Cylindrical refraction was converted to the corneal plane equivalent using the Muñoz-Escrivá equation. The Effectiveness and Safety Indexes of the procedure were also calculated. The corneal endothelial cells count (CECC) were recorded before and 24 months after the surgery. The anterior chamber depth (ACD) and endothelium-lens distances (ELD) were also analyzed.
Results
We included 45 eyes (22 OD and 23 OS) implanted with Artiflex® phakic IOL. Mean age was 32.48±7.63 years old. There was a significant improvement in BCVA using decimal scale: 0.73 to 0.94 (p<0,001). Spherical equivalent underwent an important improvement of -10.0D to -0.24D (p<0.001). The Effectiveness Index was 1.14±0.52 and the Safety Index was 1.30±0.58. Astigmatic vectors obtained statistically significant differences on B vector (p<0.001) and C45 vector (p<0.05). Regarding keratometry, there was no statistically significant difference (p<0,001). Regarding the CECC, the preoperative count was 2513.18 ± 408.41 cell/mm2 and at 24 months after surgery was 2522 ± 323.33 cell/mm2 (Wilcoxon test; Z=-1,14, p=0,254). The ACD measurement was 3.140 ± 0.264 microns. The nasal and temporal ELD were 1363.11 ± 241.97 m and 1502.00 ± 222.27 microns, respectively.
Conclusion
Phakic iris-claw IOL is an effective option for high myopia treatment. Twenty-four months after implantation of the phakic iris-claw IOL, patients had significantly reduced spherical equivalent and refractive cylinder, showing also good visual outcomes. There was no significant loss in CECC and the ELD were within the normal limits. Preoperative assessment is critical for the safety of the surgical procedure.